Drug abuse continues to have major public health consequences. Yet, validated, quantitative drug abuse surveillance tools are limited. Several national drug abuse surveillance systems have ceased operating or been substantially curtailed in recent years. This proposal aims to address these limitations by developing the methodology and establishing the feasibility of a drug-surveillance system based on quantifying illicit drugs, other drug-use indicators including metabolites and synthesis precursors, and human biomarkers in raw influent entering municipal wastewater treatment plants (WWTP) that process human waste. WWTPs have known catchment areas with specific geographic boundaries, population estimates, and volumetric flows that allow for the analysis of trends in community drug discharge over time and between locations. The primary substance of interest for this proposal is methamphetamine, which will be quantified along with several other drugs of abuse (illicit and pharmaceutical) along with selected metabolites and human population biomarkers. AIMS: 1) Develop and validate a sensitive and selective analytical method for quantifying the concentration of methamphetamine, other illicit and pharmaceutical drugs in 24 hr, flow-normalized composites of raw influent entering WWTPs;2) Develop procedures for obtaining samples from a diverse set of WWTPs;3) Determine the geographic and temporal (seasonal, day of week) variability of drug excretion on a per capita and community basis in order to describe use patterns and to develop sampling frames with optimal efficiency;and 4) Determine the correlation between measured drug discharge estimates and other drug use indicator data. To meet these aims, we propose to collect 24 hr, flow-normalized samples of raw influent from 20 WWTPs throughout Oregon and Washington for one year. A minimum of 52 samples will be obtained from each WWTP using a stratified, time-based sampling plan that will incorporate seasonal and interday variation. Methamphetamine and other drugs of abuse are readily detected and uniquely identifiable by liquid chromatography/tandem mass spectrometry. WWTPs provide coverage to more than 100 cities and towns in Oregon and Washington. Current drug surveillance data indicate substantial geographic heterogeneity in rates of drug use throughout the Pacific Northwest. Our proposal has the support of diverse, local stakeholders including public health, drug treatment, law enforcement, and WWTP managers. The findings of this R21 can be used 1) to provide research tools to examine a range of questions regarding differences in drug use by linking WWTP influent data to other geocoded data, 2) to provide local planners with validated, quantitative findings that can be used to inform allocation decisions for prevention and intervention efforts and for outcome evaluations, 3) by environmental chemists to refine analytical methods for detecting licit and illicit drugs, 4) to evaluate other geographic areas, 5) for emergent outbreak investigations, and 6) to create baseline data for future longitudinal and geographic analyses. PUBLIC HEALTH RELEVANCE: This proposal directly addresses public health both in terms of its content and methods. Drug abuse has substantial public health consequences including morbidity and mortality due to the use and abuse of both licit and illicit substances. Methodologically this proposal develops a low-cost method for monitoring community level drug abuse trends as well as a means to conduct outbreak investigations.